Search HIVST

Informing targeted HIV self-testing service delivery in Malawi and Zambia: A multi-country discrete choice experiment


Author
d’Elbee et al.

Publication year
2017

Country
Multi-country

Type of approach
Dual

Type of assistance
n/a

Specimen
Fingerstick/whole blood, Oral-fluid

Study population
General population: General population in urban, peri-urban and rural settings

Study design
Feasibility/acceptability

Sample size
1116

UNAIDS HIV prevalence (2017)
n/a

Methodology
Four Discrete Choice Experiments (DCE) were implemented within representative household surveys in Malawi and Zambia. Adults over 16 years were randomly allocated to DCE on HIV self-testing (HIVST) distribution or linkage to confirmatory testing and care. Preference heterogeneity was explored by country, age, gender and HIV testing experience.

Summary of findings
For distribution, participants (n=1116) preferred to receive HIV self-testing (HIVST) at home or at a distributor’s home rather than mobile clinics (and drugstores in Zambia only). Oral fluid tests were preferred to provider-administered or self-administered blood-based tests. HIVST distribution via sexual partner was viewed less favourably, especially among men. HIVST price had a strong negative impact on uptake. For linkage to care (n=843), phone call was preferred to SMS, a personal visit or no follow-up. The home of the HIV testing services (HTS) provider was preferred for confirmatory testing after a reactive self-test in Malawi only. Facility user fee and waiting time for confirmatory testing were strong disincentives. The Discrete Choice Experiment results were consistent across these countries with similar HIV context and suggest community-based distribution and linkage are critical aspects of HIVST delivery.

Acceptability
n/a

Acceptability details
For distribution, participants (n=1116) preferred to receive HIV self-testing (HIVST) at home or at a distributor’s home rather than mobile clinics (and drugstores in Zambia only). Oral fluid tests were preferred to provider-administered or self-administered blood-based tests. HIVST distribution via sexual partner was viewed less favourably, especially among men.

Willingness to pay
n/a

Willingness to pay details
HIVST price had a strong negative impact on uptake.

Sensitivity
n/a

Specificity
n/a

Concordance
n/a

HIV positivity
n/a

Accuracy details
n/a

Social harm
n/a

Linkage to prevention, care and treatment
For linkage to care (n=843), phone call was preferred to SMS, a personal visit or no follow-up.


Study status
Completed